Big lessons from small type: Understanding your vision benefits

For important documents or contracts, we’re often advised to read the small print. Yet when it comes to vision benefits, we could be seeing less than what’s being offered.

We know that many people have much to learn about their vision benefits. In fact, many of those with vision benefits don’t understand terminology like co-pay and allowance—only 14% of Americans understand many common insurance terms, according to a study in the Journal of Health Economics.1

Once you’re enrolled in a vision benefits package, it’s time to put your eyes to work. To help bridge the gap of understanding, you’ll first want to review your vision benefits brochure and policy documents to learn at least 3 key things:

  1. What are the services and benefits offered?
  2. What are the costs I may need to pay for those services and benefits?
  3. How can I find an eye doctor?

While reading your vision benefit materials, you’ll probably come across several common industry terms.

  • What’s a network? Your vision network is a group of eye doctors that have agreed to provide services at a rate that’s less than their usual fees. That’s why staying in-network is typically best. If you go out-of-network, you may pay more for products and services.
  • What’s a copay? A copay is the fixed amount of money you pay at the time of service when visiting an in-network eye doctor. Copays amounts will vary based on your specific vision benefits.
  • What’s an allowance? An allowance is a set amount the insurer puts toward frames or other purchases. For example, if your benefits state that you have an allowance of $100 and you purchase frames that are $150, you pay $50 out-of pocket.
  • What’s frequency? Frequency is how often you can use different parts of your benefits, such as how often you can get an eye exam or use benefits towards purchasing contact lenses. The answer will vary, but generally vision benefits cover all or part of an annual eye exam.
  • How can I use my vision benefits? Simple: review your benefits, locate an eye doctor and then make an appointment. Your vision benefits may have additional discounts that you can take advantage of, so be sure to sign up for an account on your vision benefits company’s website and review your benefits documents. At EyeMed, members enjoy discounts at in-network providers like 40% off an additional pair of glasses.2
  • Do I need antireflective coating? While not a necessity, antireflective lenses may reduce glare and reflections, making it much easier to see. If you’re bothered by glare when driving at night or spend long days working at the computer, you may benefit from these lens enhancements.3
  • What are my lens options? Your lens options will depend on the results of your eye exam. If you’re nearsighted or farsighted, you may only need single-vision or higher-powered lenticular lenses. Bifocals have a distinct line in the lens separating the magnification, helping you to see both near and far. Trifocals are similar, but with an additional section for intermediate vision. Progressive lenses accomplish essentially the same task as bifocals– providing a graduated range of vision, but without the visible line in the lens.

1. Americans Don’t Understand Insurance, Let Alone Obamacare,” by Bruce Japsen Forbes, Aug. 10, 2013, http://www.forbes.com/sites/brucejapsen/2013/08/10/americans-dont-understand-insurance-let-alone-obamacare-study-shows/
2. At participating in-network providers. Restrictions may apply. See your in-network provider for details.
3. “Buying glasses? When considering extras, keep your eyes open,” by Mary Jacobs, Dallas Morning News, May 6, 2013, http://www.dallasnews.com/lifestyles/health-and-fitness/health/20130506-buying-glasses-when-considering-extras-keep-your-eyes-open.ece